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Gaining an accurate reflection of the reality of palliative care through the use of free-text feedback in questionnaires: the AFTER study

Bowyer, Anna Victoria, Finlay, Ilora Gillian, Baillie, Jessica ORCID:, Byrne, Anthony, McCarthy, Jacqui, Sampson, Catherine ORCID:, Snow, Veronica and Nelson, Annmarie ORCID: 2019. Gaining an accurate reflection of the reality of palliative care through the use of free-text feedback in questionnaires: the AFTER study. BMJ Supportive & Palliative Care 9 (1) , e17. 10.1136/bmjspcare-2015-000920

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Background In healthcare, many service evaluation questionnaires use free-text boxes without formal mechanisms for analysis. Patients and carers spend time documenting concerns that are often ignored or managed locally in an ad hoc manner. Currently, palliative care experiences of patients and carers in Wales are measured using a service evaluation questionnaire, comprising both closed and open-ended questions. Previous research, exploring free-text responses from this questionnaire, suggests that questionnaire refinement should accommodate service users’ expressed priorities and concerns, and highlights the need to incorporate free-text data analysis strategies during study design. Methods Results from a previous analysis of 596 free-text responses provided the basis for an expert consensus day, where the current service evaluation questionnaire was refined. The refined version was tested during cognitive interviews with patients (n=10) and carers (n=7) receiving palliative care from 1 of 2 UK hospices. Data were analysed thematically. Results Interviews highlighted minor areas for change within the questionnaire and provided broader insight into patients’ experiences of palliative care services. Patients and carers place an emphasis on simplifying language, decreasing the numeric response range and reducing written instructions; relying instead on visual cues, including formatting and layout. Findings highlighted the importance patients attached to providing meaningful free-text contributions. Conclusions Questionnaire refinement should use the patient perspective to effectively facilitate respondent understanding, pertinence and usability. The importance of employing data analysis strategies during questionnaire design may reduce research waste, thus enabling a better interrogation of service provision.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
Additional Information: Published Online First 17 February 2016 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license
Publisher: BMJ
ISSN: 2045-435X
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 5 January 2016
Last Modified: 20 Jul 2023 22:31

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